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PubMed2001

Temperature-controlled radiofrequency tonsil reduction: extended follow-up.

OBJECTIVE: Initial evaluation has shown that temperature-controlled radiofrequency submucosal tonsil reduction (Tonsil Somnoplasty) effectively treats obstructive symptoms of tonsillar hypertrophy with minimal associated discomfort and rapid return to normal activity and diet. This study assesses the effects of treatment over an extended follow-up period of up to a year. STUDY DESIGN: Twelve adults with symptomatic chronic tonsil enlargement underwent an average of 1.5 treatments. Evaluation included periodic oropharyngeal airway measurements, and questionnaires on treatment morbidity and symptom improvement. RESULTS: Data on 12 patients at 3 months and 6 months, and 5 patients at 1 year show sustained increases in oropharyngeal airway size (1.7 cm/3 mo, 1.8 cm/6 mo, 2.4 cm/12 mo) and reduction in obstructive symptoms (Epworth Score decrease of 70%/3 mo, 58%/6 mo, 67%/12 mo; snoring reduction of 81%/3 mo, 79%/6 mo, 78%/12 mo) without significant differences after 3 months. A second treatment reduced tonsil size but gave variable further symptom improvement. CONCLUSION: The effects of Tonsil Somnoplasty are maintained on follow-up to 1 year.

Adult↗

PubMed2005

Effect of probiotics on intestinal mucosal immunity and ultrastructure of cecal tonsils of chickens.

Sixty chickens were randomly divided into two groups to determine the effect of oral administration of probiotics on the intestinal mucosal immune response and ultrastructure of cecal tonsils. The first group (control) was fed with a basic diet without antibiotic or probiotics. The second group was fed with the same diet as the control, except they received drinking water with probiotics (4 x 10(9) cfu per chicken and day) from posthatch to day 3 of age. The probiotic preparation was composed of Bacillus subtilis Bs964, Candida utilis BKM-Y74 and Lactobacillus acidophilus LH1F. Intestinal fluid, Peyer's Patch and cecal tonsils were taken at day 1, 4, 7, 10 and 18 after administration of probiotics. The results showed: (i) Compared to the control, probiotics enhanced the content of following items: immunglobulin (Ig)A in the intestinal fluid at day 7 (p < 0.01), the IgG-forming cells at day 10 (p < 0.05), IgM-forming cells in the Peyer's Patch at day 7 (p < 0.05), IgA-forming cells at day 7-10 (p < 0.05), IgG-forming cells at day 7 (p < 0.05) and IgM-forming cells in cecal tonsils diffuse area at day 4-7 (p < 0.05). (ii) T lymphocytes in cecal tonsils were enhanced at day 7 (p < 0.01) after orally fed with probiotics. (iii) The density of microvilli and length of cecal tonsils increased after probiotics were administrated at day 3. With chicken ageing, the efficiency of probiotics would decrease. These results suggested that probiotics enhance intestinal mucosal immunity of chicken at the early age.

Administration, Oral↗

PubMed1996

Bacteriologic findings in tonsillitis and pericoronitis.

Bacteriologic samples from 31 young men were cultured quantitatively for aerobes and anaerobes; these samples included 31 specimens of tonsils (16 infected and 15 healthy), 16 specimens from pericoronal pockets of lower third molars (11 infected and 5 symptom-free), and 6 postoperative specimens from lower-third-molar extraction sockets. Anaerobes were isolated more often from infected third molars than from infected tonsils (14.5 isolates vs. 8.4 isolates, respectively; P < .001). Infected tonsil samples contained significantly more anaerobic species if an adjacent partly erupted lower third molar was present rather than absent (10.3 isolates vs. 6.9 isolates, respectively; P < .05). Eubacterium aerofaciens, Clostridium species, Peptostreptococcus micros, and Prevotella oris were frequently isolated. Streptococcus salivarius was found more frequently in tonsillar specimens, whereas Corynebacterium species, Prevotella denticola, Capnocytophaga species, Peptostreptococcus anaerobius, and Lactobacillus species were more common in pericoronal pocket samples. Thus, partial eruption of lower third molars increases the number of anaerobic bacterial species on tonsils and many species can be isolated simultaneously from both tonsils and lower third molars.

Adolescent↗

PubMed1990

Cranio-facial morphology in children with and without enlarged tonsils.

The purpose of the present study was to compare the cranio-facial morphology in children with and without enlarged tonsils. The material consisted of 73 children with enlarged tonsils, and a control group of children with normal tonsils, matched for age, sex, and number. The mean age for the groups was 10.1 and 10.0 years, respectively. Evaluation of anamnestic history, clinical examination, and lateral skull radiographs were undertaken. Compared to the control children, the children with enlarged tonsils had more retrognathic and posteriorly inclined mandibles, larger anterior total and lower facial heights, and larger mandibular plane angles. Regression analyses revealed that functional, postural, and morphological factors, such as open mouth posture, low posture of the tongue, large depth of oropharynx at the site of the tonsils as well as mouth-breathing at night, were associated with skeletal features expressing an increased open vertical configuration and mandibular retrognathism.

Cephalometry↗

PubMed1990

Posture of the head, the hyoid bone, and the tongue in children with and without enlarged tonsils.

The purpose of this investigation was to analyse whether there were any differences between children with and without enlarged tonsils with regard to the posture of the head, the hyoid bone, and the tongue. Twenty-two children with enlarged tonsils were compared with a matched normal control group. Of the children in the tonsil group, 59 per cent were mouth-breathers during the day and 82 per cent during the night. None of the control children was a mouth-breather. The results showed that, compared with the control children, children with enlarged tonsils had an extended posture of the head, a lowered position of the hyoid bone, and an antero-inferior posture of the tongue. The vertical position of the hyoid bone also reflected the vertical position of the tongue. The antero-posterior position of the tongue was closely related to the oro-pharyngeal depth. The postural pattern in children with enlarged tonsils appears to be associated with the need for maintenance of free oro-pharyngeal airway capacity.

Adolescent↗

PubMed1989

Dentition in children with enlarged tonsils compared to control children.

The aim of the present study was to evaluate whether or not there are any differences in the dentition between children with enlarged tonsils and those with normal tonsils. A sample of 73 children (33 boys and 40 girls) with enlarged tonsils and with a mean age of 10.1 years was compared with a normal control group, matched for age and sex. Eighteen dentition variables and thirty-two variables in anamnestic, clinical, pharyngeal and postural findings were recorded. Measurements were obtained from lateral skull radiographs and dental casts. Group means were compared. Relationships between variables were studied using simple correlations and multiple stepwise regression analyses. It was found that children with enlarged tonsils had more retroclined lower incisors, more anteriorly positioned upper incisors, smaller overbite, larger overjet, shorter lower dental arches, narrower upper dental arches and an increased frequency of lateral crossbite. Functional and/or morphological disorders, causing an open posture of the mouth, a lowered anterior posture of the tongue and a low position of the hyoid bone are thought to be associated with the differences in the dentition between the two groups. Obstruction of the oropharynx by enlarged tonsils, might be one factor responsible for these dysfunctions.

Adenoidectomy↗

PubMed1986

Lingual tonsillitis.

Lingual tonsillitis can cause various signs and symptoms including nocturnal or supine cough, constant discomfort in the throat, glossal pain, and otalgia. Most patients with lingual tonsillitis have already had palatine tonsillectomy. A lingual tonsil may be visible only by using a laryngeal mirror. An embedded foreign body can cause recurrent tonsillitis with abscess formation, and life-threatening airway obstruction may result. Aberrant lingual thyroid may be the only functioning thyroid tissue. Cryosurgery and the CO2 laser have made lingual tonsillectomy a safe and simple procedure. An abscess of a lingual tonsil should be drained under general anesthesia, and lingual thyroid should be treated conservatively unless it produces obstructive symptoms.

Abscess↗

PubMed1993

Immunohistochemical detection of co-localizing cytokine and antibody producing cells in the extrafollicular area of human palatine tonsils.

In vitro experiments have documented the role of cytokines in the regulation of the human humoral immune response. Which cytokines are operative in vivo and in which lymphoid compartment interactions between cytokine-producing T cells and antibody-forming B cells occur is still unclear. For that reason we studied human tonsils using immunohistochemical techniques. In tissue sections from tonsils in a resting stage after recurrent tonsillitis we observed cells producing IL-1 alpha and tumour necrosis factor-alpha (TNF-alpha) which were exclusively localized in the mantle zone of the follicle and in the extrafollicular area. Furthermore, a high frequency of interferon-gamma (IFN-gamma)-producing cells was detected in the extrafollicular area, but not inside the follicles. Occasional IL-2- and IL-4-producing cells were found in the extrafollicular area. Immunohistochemical detection of antibody isotypes revealed that B cells, IgM-membrane-positive, were localized inside the follicles and mantle zones, whereas IgD-membrane-positive cells were mainly found in the mantle zones of secondary follicles. In contrast, plasma cells producing IgG1-4 and IgA1-2 were found in the extrafollicular area. No IgD and IgE antibody-forming cells were detected in tonsils, whereas IgM antibody-forming cells were detected in the extrafollicular area. The co-localization of cytokine-producing cells and antibody-forming cells in human tonsil suggests that T-B cell interactions, required for B cell differentiation and isotype switching, take place in the extrafollicular area.

Antibody-Producing Cells↗

PubMed1994

Immunopathological features of palatine tonsil characteristic of IgA nephropathy: IgA1 localization in follicular dendritic cells.

IgA nephropathy (IgAN) is generally thought to be mediated by the glomerular deposition of circulating immune complexes containing IgA as the major antibody component. Upper respiratory infections and tonsillitis often precede IgAN, and in some cases tonsillectomy is effective for the treatment of IgAN. Thus, the tonsil seems to be a unique organ causing initial and/or progressive events to generate nephritogenic immune complexes in IgAN. In this study we focused on the analysis of immunopathological features of the palatine tonsil characteristic of IgAN patients by using an immunohistochemical technique. The IgA1 subclass was demonstrated in follicular dendritic cells (FDC) of the tonsil of IgAN patients, but not in FDC of non-IgAN controls. On the other hand, IgA2, IgG, IgM and C3 did not show any differences in distribution between the two groups. Moreover, the expression of decay-accelerating factor (DAF), an inhibitor of homologous complement activation, and transforming growth factor-beta 1 (TGF-beta 1), an inducer of antibody-producing cells to IgA class switching, in FDC and interdigitating dendritic cells of the tonsil, respectively, which was also clarified in this study for the first time, was found to be identically distributed in the two groups. These findings may support the idea that IgA1, possibly in an immune complex form, is trapped by FDC and plays an important role in the persistent activation of particular B cell repertoires responsible for the onset and/or progression of IgAN.

Adolescent↗

PubMed1994

In vitro effects of H1-antihistamines on histamine and PGD2 release from mast cells of human lung, tonsil, and skin.

Mast cells from different anatomic sites differ in cytochemistry and response to various secretory stimuli. We have investigated whether responsiveness to the second-generation H1-receptor antagonists, which are important first-line drugs for the relief of symptoms in patients with chronic urticaria and allergic rhinoconjunctivitis, also differs according to the site of origin of mast cells. The effects of terfenadine, ketotifen, and cetirizine were therefore examined in relation to the IgE-dependent release of histamine and prostaglandin D2 (PGD2) from dispersed human lung, tonsil, and skin mast cells. Terfenadine had a biphasic effect on lung and skin mast cells: at low concentrations, a concentration-dependent inhibition of histamine release from lung and skin mast cells was observed, whereas at higher concentrations the drug stimulated mediator release. Even at a high concentration, terfenadine inhibited mediator release from tonsil mast cells. Ketotifen had low potency as an inhibitor of mediator release from lung and tonsil mast cells. In skin mast cells, no inhibition of mediator release was observed below 1.0 microM, and above that concentration it induced mediator release. Cetirizine, a much less lipophilic drug than the others tested, did not induce mediator release from mast cells even at concentrations up to 100 microM. This drug showed concentration-dependent inhibition of IgE-dependent mediator release from lung and tonsil mast cells only. Our results show that human mast cells are heterogeneous with respect to modulation of mediator release by these H1-antihistamines. In particular, differences were observed between skin mast cells and those dispersed from lung and tonsils.

Cetirizine↗

PubMed2005

Histology, immunohistochemistry and ultrastructure of the equine tubal tonsil.

The tubal tonsil of the horse surrounds the pharyngeal opening of the eustachian tube and is lined by pseudostratified columnar ciliated epithelium interspersed with areas of follicle-associated epithelium (FAE) heavily infiltrated by lymphocytes but devoid of goblet and ciliated cells. Scanning and transmission electron microscopy revealed microvillous cells and cells with features characteristic of M cells such as reduced microvilli or depressed bare surface, more numerous mitochondria, small vesicles and lysosomes, as well as vimentin filaments and epitopes specific for GS 1-B4 as previously seen in the nasopharyngeal tonsil. M cells were also identified in areas of respiratory epithelium not associated with lymphoid follicles and appeared to be the nasal mucosal counterparts of recently described intestinal villous M cells in the mouse. The underlying lymphoid tissue of the FAE was generally organized as solitary lymphoid follicles without germinal centres in contrast to the diffuse and large amount of organized lymphoid follicles with germinal centres that characterize the nasopharyngeal tonsil. CD8+ T and B-lymphocytes were much fewer than in the nasopharyngeal tonsil. High endothelial venules were mainly oriented towards the parafollicular area and contained much fewer endothelial pores and vesiculo-vacuolar organelles. Finally, scattered small clusters of mucus acini and striated muscles were other features that differentiated the tubal and nasopharyngeal tonsils.

Animals↗

PubMed2005

Activation of human tonsil and skin mast cells by agonists of proteinase activated receptor-2.

AIM: To investigate the effects of the agonists of proteinase activated receptor (PAR)-2, and histamine on degranulation of human mast cells. METHODS: Human mast cells were enzymatically dispersed from tonsil and skin tissues. The dispersed cells were then cultured with various stimuli, and tryptase and histamine levels in cell supernatants collected from challenge tubes were measured. RESULTS: PAR-2 agonist peptide SLIGKV provoked a dose-dependent release of histamine from skin mast cells. It also induced tryptase release from tonsil mast cells. tc-LIGRLO appeared less potent than SLIGKV in induction of release of histamine and tryptase. Trypsin was able to induce a bell shape increase in tryptase release from tonsil mast cells. It was also able to induce a dose-dependent release of histamine from both tonsil and skin mast cells. The actions of trypsin on mast cells were inhibited by soy bean trypsin inhibitor (SBTI) or alpha1-antitrypsin (alpha1-AT). Time course study revealed that both stimulated tryptase or histamine release initiated within 10 s and reached their peak release between 4 and 6 min. Pretreatment of cells with metabolic inhibitors or pertussis toxin reduced the ability of mast cells to release tryptase or histamine. CONCLUSION: It was demonstrated that the in vitro tryptase release properties of human tonsil and skin mast cells suggested a novel type of mast cell heterogeneity. The activation of mast cells by PAR-2 agonists indicated a self-amplification mechanism of mast cell degranulation.

Antibodies, Anti-Idiotypic↗

PubMed1984

Carrier rate of Streptococcus suis capsular type 2 in palatine tonsils of slaughtered pigs.

Palatine tonsils of 143 slaughtered pigs aged 4 to 6 months were investigated for the presence of Streptococcus suis type 2. Slices (50 micron) of frozen tonsils were cultured on a selective agar medium containing antibodies against S. suis type 2 in which colonies of this bacterium showed a halo of immunoprecipitation. When tonsils were sectioned in one plane S. suis type 2 was found in 45 of 143 pigs (32%). This percentage increased to 50% when tonsils were sectioned in more then one plane, which was done on 55 tonsils. The first 45 strains showing a ring of immunoprecipitation were studied and found to be biochemically identical to our reference strain 735 (de Moor) and to 23 isolates from human patients with meningitis. In slices incubated for 24 h at 37 degrees C on selective agar plates and stained with hematoxylin and eosin after fixation, it could be demonstrated that S. suis type 2 was confined to the crypt lumen. The same was true in sections fixed directly (without incubation) that were stained by an indirect immunoperoxidase method with a rabbit anti-S. suis type 2 serum.

Abattoirs↗

PubMed1976

Concentration of immunoglobulins in the tonsils.

The concentration of various immunoglobulins in the faucial tonsil was determined and expressed as a portion of the total protein centration of IgA rises with age while that of IgM falls. IgE was found to be relatively high and the highest levels of all immunoglobulins examined were noted in hypertrophied tonsils. They were lowest in the atrophic tonsils of children and in adult tonsils. The results are discussed in their relevance to the overall immunological function of the faucial tonsil.

Adult↗

PubMed1978

Description of age-depending cellular changes in the human tonsil.

The growth and ageing of tonsils is described by means of the behaviour of the cell count, T cell count, DNA, and organ weight. Proliferation of cells and the influx of recirculating T lymphocytes cause hyperplasia up to the age of 17 approximately, later on the cell count and organ weight decrease again. The number of T cells in cell suspensions from the tonsil is lower than that of blood. Due to the proliferation decrease of B cells and the accumulation of recirculating T lymphocytes, the T cell count in the tonsil increases with advancing years. The tonsil function decrease as a result of this population shift. No influence of the differentiation of T cells by the tonsil can be detected.

Aging↗

PubMedDate not supplied

Papillary hypertrophy of the palatine tonsils.

Papillary hypertrophy of the tonsils is one of the rare abnormalities of the palatine tonsils. Since the first reports of papillary hypertrophy of the tonsils by Ogino and Matsui, only 30 cases of this disease have been reported in Japan. The etiology of papillary hypertrophy remains a myster. A 5-year-old female visited our clinic with a complaint of obstructive feeling in the throat. Papillary surface of the palatine tonils were noticed. Tonsillectomy and adenoidectomy were performed under general anesthesia on October 25, 1977. the histopathological examination of the tonsils revealed the lymphoid hyperplasia with poor subepithelial connective tissues. Only slight chronic inflammation was present. This papillary hypertrophy of the tonsils was found in 13 members (6 male, 7 female) of her family pedigree. Genetical analysis of the pedigree showed this disease is transmitted by an autosomal dominant gene.

Adolescent↗

PubMedDate not supplied

Association of Epstein-Barr virus with acute exudative tonsillitis.

This report is concerned with acute exudative tonsillitis as a pathologic response to the Epstein-Barr virus (EBV). The concept of a bacterial-viral etiology etiology for tonsillitis has been suggested, and previous studies implicate EBV as a major pathogen in exudative tonsillitis. A prospective study of 16 patients with this diagnosis was conducted. EBV serologic data plus viral and bacterial throat cultures were compiled and evaluated. EBV as a casual agent alone or concurrent with other organisms was seen in 56% (9) of the patients under study. EBV activation was associated with infection by other organisms in 19% (3) of the cases. The overall total incidence of EBV in association with severe acute exudative tonsillitis was 75% (12). The data further documents EBV as a significant causal or associative agent in acute exudative tonsillitis.

Acute Disease↗

PubMed1991

Colonization of the pharyngeal tonsil and respiratory tract of the gnotobiotic pig by a toxigenic strain of Pasteurella multocida type D.

Seven-day-old gnotobiotic pigs were inoculated intranasally with Pasteurella multocida and euthanatized 2, 5, 9, and 14 days after inoculation. Tissues from the oropharynx and respiratory tract of pigs were cultured quantitatively and analyzed microscopically. Pigs remained afebrile and alert, except one that died of acute fibrinopurulent pneumonia. Pasteurella multocida was isolated in greatest numbers from the pharyngeal tonsils, but only in low numbers from turbinate, trachea, lung, spleen, and liver. Significant histologic changes were limited to the tonsil. Infected pigs developed mild tonsillitis with lymphocytic hyperplasia, and accumulation of cell debris and bacteria in crypts. Capsular antigens of P. multocida, identified on tissue sections with rabbit anti-capsular polysaccharide antibody and immunocytochemical reagents, were confined to the crypt lumen. Ultrastructurally, bacteria were free within crypt material or within phagosomes of macrophages or neutrophils. In a second experiment, 5-day-old pigs were infected with Streptococcus suis type 2, followed by toxigenic Pasteurella multocida at 7 days of age; one pig died of streptococcal septicemia. Pigs developed a mild tonsillitis, and both bacteria were cultured from the tonsillar crypts for up to 14 days after infection. These studies show that a toxigenic strain of Pasteurella multocida, which is a causative agent of atrophic rhinitis, can colonize the tonsil and respiratory tract of gnotobiotic pigs for up to 14 days. In addition, colonization can occur concurrently with Streptococcus suis type 2.

Animals↗